By ML Mazaba
Zambia National Public Health Institute ZNPHI
Citation Style For This Article: Mazaba ML. Malaria: The Journey To Elimination. Health Press Zambia Bull. 2019; 3(4); pp 1-2.
The Health Press – Zambia invites you to read its 4th issue in 2019. In this issue, we publish an article “The Additional Effect of Focal Indoor Residual Spraying on Incidence of Malaria in Setting with High Insecticide Treated Bed Nets Coverage in Mansa District, Luapula Province” and a fact sheet on Malaria to celebrate with the world, World Malaria Day which fell on 25th April 2019. The editorial also focuses on documenting the journey in the malaria elimination agenda. We also publish an original paper titled “Typhoid in Zambia: An analysis of cases reported between 2016 and 2018”. Please enjoy the read that prevention of disease and ensuring health security starts at the individual level, so let us all be a part.
Malaria: The Journey to Elimination
A move to eliminate Malaria from the globe has been embraced by many if not all countries with WHO declaring to support member states eradicate Malaria leveraging on the Abuja Declaration in 2000 preceded by the 1998 Roll Back Malaria initiative, launched by WHO. The World Health Organisation defines elimination as the interruption of local transmission where there is zero incidence of cases of the indigenous specified Malaria causing parasitic species in a defined geographic area. The progress by countries in the elimination agenda is at different levels considering the different factors that influence this progression; strength of health systems, level of investment, demographic, social and environmental determinants as well as economic realities and political will .
By 2017, many countries reported significant reductions in the morbidity and mortality rates with 17 countries having eliminated malaria since 2000. The World Health Organisation has since certified at-least 9 endemic countries as Malaria free since 2000; United Arab Emirates, 2007, Morocco, 2010, Turkmenistan, 2010, Armenia, 2011, Maldives, 2015, Sri Lanka, 2016, Kyrgyzstan, 2016, Paraguay (2018) and Uzbekistan (2018).
The WHO 2016 report indicated that although good progression of malaria control occurred in Africa the global progress was off-track . According to Spirit of America, project manager for Africa Andy Duhon , in 2016, 91% of the 445,000 deaths due to malaria globally were in Africa with almost two thirds being children under five years of age . Appreciating the progress is notable; many countries within the African regions remain challenged in the journey to elimination owing to inadequate financial resources and fragile health systems. The progress in control towards elimination in Africa, more-so Southern Africa is attributed to increase in prophylaxis treatment for pregnant women and constant use of insecticide-treated nets .
A partnership initiative by 8 African countries; Botswana, Mozambique, Namibia, South Africa, Swaziland, Zambia, and Zimbabwe named the Elimination 8 (E8), is in place to foster accelerated zero local transmission of Malaria by 2020 for four countries (Botswana, Namibia, South Africa, and Swaziland) and 2030 for the other four countries through collaboration and joint strategic programming . Despite the progress, noted is the highly heterogeneous distribution in this sub-Saharan region. Botswana and Namibia reported an escalation in malaria incidence during the 2016/2017 malaria season. South Africa and Zimbabwe have also recorded increase in the incidence owing to displacement of populations due to the heavy rains. Meanwhile, although Mozambique has also recorded an increase in number of cases in its northern region, progress towards elimination in southern pre-elimination provinces of Maputo and Maputo is noted. Swaziland maintains its gains and Zambia has impressive progress towards control and elimination especially compared to other countries in the neighbourhood .
Zambia celebrated along the world on 25th April 2019; World Malaria Day dubbed “Zero Malaria Starts with Me” and localized it with a theme “Malaria Ends With Me” carrying the slogan “A Malaria-Free Community Starts with Me”